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Serum Levels of miR-143 Predict Survival in Critically Ill Patients.

ABSTRACT: Background and Aims:Recent data suggested a potential role of miR-143 as a biomarker for systemic inflammation and infection. However, its role in critical illness and sepsis is only poorly understood. Methods:We determined circulating levels of miR-143 in 218 critically ill patients, of which 135 fulfilled sepsis criteria, and compared them to 76 healthy controls. Results were correlated with clinical records. Results:In the total cohort of critically ill patients from a medical intensive care unit (ICU), miR-143 serum levels tended to be lower compared to healthy control samples, but this difference did not reach statistical significance. In ICU patients, serum levels of miR-143 were independent of disease etiology, including the presence of sepsis, or severity of disease. Importantly, low miR-143 serum levels were associated with an unfavorable short- and long-term prognosis in ICU patients. Our study identified different optimal cut-off values at which low miR-143 serum levels predicted mortality with a high diagnostic accuracy. In line with this, concentrations of circulating miR-143 correlated with markers of organ failure such as creatinine, bilirubin, or lactate in our cohort of critically ill patients. Conclusion:Low miR-143 serum levels are indicative for an unfavorable short- and long-term prognosis in critically ill patients admitted to a medical ICU. Our data suggest a previously unrecognized role for miR-143 measurements as a novel prognostic marker in critically ill patients.

SUBMITTER: Roderburg C

PROVIDER: S-EPMC6854254 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Serum Levels of miR-143 Predict Survival in Critically Ill Patients.

Roderburg Christoph C Koch Alexander A Benz Fabian F Vucur Mihael M Spehlmann Martina M Loosen Sven H SH Luedde Mark M Rehse Sebastian S Lurje Georg G Trautwein Christian C Tacke Frank F Luedde Tom T

Disease markers 20191023

<h4>Background and aims</h4>Recent data suggested a potential role of miR-143 as a biomarker for systemic inflammation and infection. However, its role in critical illness and sepsis is only poorly understood.<h4>Methods</h4>We determined circulating levels of miR-143 in 218 critically ill patients, of which 135 fulfilled sepsis criteria, and compared them to 76 healthy controls. Results were correlated with clinical records.<h4>Results</h4>In the total cohort of critically ill patients from a m ...[more]

PMID: 31772686

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Project description:Thyroid dysfunction is common in critical illness and may influence prognosis. However, the value of TSH in patients with severe diseases remains unclear. The aim of this study was to investigate the association between TSH and the clinical prognosis of critically ill patients. Methods: This retrospective study identified patients who were admitted to the ICU in the Medical Information Mart for Intensive Care (MIMIC-IV) database (version 2.2). A total of 6432 patients were divided into four groups based on TSH quartiles (Q1, <0.92 mIU/L; Q2, 0.92-1.07 mIU/L; Q3, 1.07-3.10 mIU/L; Q4, >3.10 mIU/L). The clinical outcomes were defined as all-cause 7-, 30-, and 90-year mortality after ICU admission. Restricted cubic splines (RCSs) for nonlinear associations were generated to visualize the relationship between TSH levels and clinical outcomes. The survival differences among the four groups were also analyzed using Kaplan‒Meier curves and log rank tests. Univariable and multivariable Cox proportional hazards regression were further used to assess the association between TSH levels and clinical outcomes. Results: After multivariate adjustment, a U-shaped relationship was observed between TSH levels and all-cause 7-, 30-, and 90- mortality among patients with severe disease (all P < 0.05 for nonlinearity). The plot showed a risk reduction in the low range of TSH, which reached the lowest risk at approximately 2.9 μIU/mL and then increased thereafter. Compared with patients with Q3 TSH levels, those with Q1, Q2, and Q4 TSH levels had a significantly higher risk of all-cause 30-day mortality (Q1: hazard ratio, 1.28; 95% CI, 1.06-1.54; Q2: hazard ratio, 1.22; 95% CI, 1.01-1.48; Q4: hazard ratio, 1.25; 95% CI, 1.04-1.50). For all-cause 90-day mortality, only the Q4 group had a significantly higher mortality risk than the Q3 group (hazard ratio, 1.24; 95% CI, 1.07-1.44). In subgroup analyses, we found that Q1 TSH levels were associated with higher mortality risk in men and older (≥65 years) patients, while Q4 TSH had a greater risk in men and younger (<65 years) patients. Conclusions: TSH was significantly associated with all-cause 7-, 30-, and 90-day mortality in critically ill patients after admission to the ICU. TSH may serve as a valuable biomarker for risk stratification in critically ill patients.

Project description:BackgroundInterleukin-17 (IL-17) antagonism in rats reduces the severity and progression of AKI. IL-17-producing circulating T helper-17 (TH17) cells is increased in critically ill patients with AKI indicating that this pathway is also activated in humans. We aim to compare serum IL-17A levels in critically ill patients with versus without AKI and to examine their relationship with mortality and major adverse kidney events (MAKE).MethodsMulticenter, prospective study of ICU patients with AKI stage 2 or 3 and without AKI. Samples were collected at 24-48 h after AKI diagnosis or ICU admission (in those without AKI) [timepoint 1, T1] and 5-7 days later [timepoint 2, T2]. MAKE was defined as the composite of death, dependence on kidney replacement therapy or a reduction in eGFR of ≥ 30% from baseline up to 90 days following hospital discharge.ResultsA total of 299 patients were evaluated. Patients in the highest IL-17A tertile (versus lower tertiles) at T1 had higher acuity of illness and comorbidity scores. Patients with AKI had higher levels of IL-17A than those without AKI: T1 1918.6 fg/ml (692.0-5860.9) versus 623.1 fg/ml (331.7-1503.4), p < 0.001; T2 2167.7 fg/ml (839.9-4618.9) versus 1193.5 fg/ml (523.8-2198.7), p = 0.006. Every onefold higher serum IL-17A at T1 was independently associated with increased risk of hospital mortality (aOR 1.35, 95% CI: 1.06-1.73) and MAKE (aOR 1.26, 95% CI: 1.02-1.55). The highest tertile of IL-17A (vs. the lowest tertile) was also independently associated with higher risk of MAKE (aOR 3.03, 95% CI: 1.34-6.87). There was no effect modification of these associations by AKI status. IL-17A levels remained significantly elevated at T2 in patients that died or developed MAKE.ConclusionsSerum IL-17A levels measured by the time of AKI diagnosis or ICU admission were differentially elevated in critically ill patients with AKI when compared to those without AKI and were independently associated with hospital mortality and MAKE.

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Serum Levels of miR-143 Predict Survival in Critically Ill Patients.

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Serum Levels of miR-143 Predict Survival in Critically Ill Patients.

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